Derik S Evenson (NPI# 1295910651, PAC ID# 1456436427) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.
| Nation Provider ID (NPI) | 1295910651 |
| PAC ID by PECOS | 1456436427 |
| Professional Enrollment ID | I20170626000212 |
| Full Name | Derik S Evenson |
| Organization Legal Name | PORT HURON PHYSICIANS MEDICAL GROUP PC |
| Address |
1985 Gratiot Blvd Marysville MI 48040-2215 |
| Phone Number | 8103640692 |
| Gender | M |
| Graduation Year | 2007 |
| Primary Specialty | NURSE PRACTITIONER |
| Group Practice PAC ID | 0840507802 |
| Number of Group Practice Members | 8 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 230031 | LAKE HURON MEDICAL CENTER |
| 230216 | MCLAREN PORT HURON |
| Address | Phone | Organization |
|---|---|---|
| 1985 Gratiot Blvd, Marysville, MI 48040-2215 | 8103640692 | PORT HURON PHYSICIANS MEDICAL GROUP PC |
| Organization Legal Name | PORT HURON PHYSICIANS MEDICAL GROUP PC |
| Physicians | 13 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Robert J Sachs | Internal Medicine | Port Huron Physicians Medical Group PC | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884 |
| Dawn Elaine Morey | General Surgery | Port Huron Physicians Medical Group PC | 2609 Electric Ave B, Lake Huron Med Grp, Port Huron, MI 48060-6589 |
| Patrick A Kut | Family Medicine | Port Huron Physicians Medical Group PC | 2603 Electric Ave, 3 Lake Huron Med Grp, Port Huron, MI 48060-6588 |
| Philip Milan Matich | Family Medicine | Port Huron Physicians Medical Group PC | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884 |
| Gaurav Bhalla | Internal Medicine | Port Huron Physicians Medical Group PC | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884 |
| Aaron J Overly | General Surgery | Port Huron Physicians Medical Group PC | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884 |
| Shilpin A Mehta | General Surgery | Port Huron Physicians Medical Group PC | 2609 Electric Ave B, Lake Huron Med Grp, Port Huron, MI 48060-6589 |
| Krishna D Valjee | General Surgery | Port Huron Physicians Medical Group PC | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884 |
| Sushma Reddy | Endocrinology | Port Huron Physicians Medical Group PC | 4190 24th Ave, Suite 206, Fort Gratiot, MI 48059-3884 |
| Arunthathi T Stallwood | Internal Medicine | Port Huron Physicians Medical Group PC | 1985 Gratiot Blvd, Marysville, MI 48040-2215 |
| Street Address |
1985 GRATIOT BLVD |
| City | MARYSVILLE |
| State | MI |
| Zip | 48040-2215 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Rigel M Galera | Family Medicine | Vpa PC | 1985 Gratiot Blvd, C, Marysville, MI 48040-1200 |
| Edgar A Pou | Family Medicine | Vpa PC | 1985 Gratiot Blvd, C, Marysville, MI 48040-1200 |
| Joji Alex | Nurse Practitioner | Vpa PC | 1985 Gratiot Blvd, C, Marysville, MI 48040-1200 |
| Arunthathi T Stallwood | Internal Medicine | Port Huron Physicians Medical Group PC | 1985 Gratiot Blvd, Marysville, MI 48040-2215 |
| Amgad L Nashed Awad | Family Practice | Iah of Michigan Pllc | 1985 Gratiot Blvd, Marysville, MI 48040-2215 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Ramica Ford | Chiropractic | 1124 Gratiot Blvd, Marysville, MI 48040-1133 | |
| Jessica A Onufrak | Nurse Practitioner | Physician Healthcare Network PC | 1600 Gratiot Blvd, Marysville, MI 48040-1145 |
| Michelle M Rousseau | Psychologist, Clinical | Emca Counseling PC | 1600 Gratiot Blvd, Bldg B, Marysville, MI 48040-1145 |
| Courtney L Mcclellan | Clinical Social Worker | Emca Counseling PC | 1600 Gratiot Blvd, Bldg B, Marysville, MI 48040-1145 |
| Dianna L Pratt | Psychologist, Clinical | Emca Counseling PC | 1600 Gratiot Blvd, Bldg B, Marysville, MI 48040-1145 |
| Katrina Louise Stachowiak | Physician Assistant | Physician Healthcare Network PC | 1600 Gratiot Blvd, Marysville, MI 48040-1145 |
| Todd Patrick Stachowiak | Physician Assistant | Physician Healthcare Network PC | 1600 Gratiot Blvd, Marysville, MI 48040-1145 |
| Rodney D Mclane | Chiropractic | 1600 Gratiot Blvd, Suite 6, Marysville, MI 48040-1145 | |
| Kelly Ann Wright | Physician Assistant | Physician Healthcare Network PC | 1600 Gratiot Blvd, Marysville, MI 48040-1145 |
| Daniel Joseph Wilhelm | Pediatric Medicine | Physician Healthcare Network PC | 1600 Gratiot Blvd, Marysville, MI 48040-1145 |
| Find all physicians in zip 48040 | |||
| City | MARYSVILLE |
| Zip Code | 48040 |
| Specialty | NURSE PRACTITIONER |
| City + Specialty | MARYSVILLE + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Derik S Evenson.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.